Bronchial CA Flashcards

1
Q

Main risk factors of bronchial CA

A
  • Cigarette smoking
  • Passive smoking (1.5 times greater)
  • Occupation exposure – arsenic, chromium,
    iron oxide
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2
Q

Main two types of bronchial CA

A
  1. Small cell CA – 3 years, initial malignant
    change to presentation
  2. Non-small cell CA – 15 year for Adeno CA, 8
    years for squamous CA
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3
Q

Non small cell CA types

A

Squamous CA
Adeno CA
Large cell CA
Bronchoalveolar CA

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4
Q

Early presentation type of bronchial CA

A

Small cell CA

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5
Q

Most common Bronchial CA type

A

Squamous CA

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6
Q

CA seen in almost exclusively in smokers

A

Squamous cell CA

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7
Q

Central and cavitating type of bronchial CA

A

Squamous cell CA

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8
Q

Presentation of squamous CA

A

Obstructive lesion to bronchus presenting as infection

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9
Q

squamous cell CA is well differentiated (T/F?)

A

True

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10
Q

Local spread is common in Squamous cell CA

A

True

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11
Q

widespread mets are common in small cell CA

A

False. It’s rare

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12
Q

AdenoCA is mostly peripherally located

A

True

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13
Q

Adeno CA arises from mucous cells from the alveolar epithelium

A

False. mucous cells from the bronchial epithelium

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14
Q

Adeno CA most common invading sites

A

Invasion to pleura, mediastinal lymph
nodes, metastasis to brain, adrenal gland
and bones

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15
Q

Adeno CA is mostly associated with….

A

non- smokers and asbestos

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16
Q

what is the less differentiated forms of squamous cell CA and adeno CA

A

Large cell CA

17
Q

bronchial CA that presents as diffuse or solitary nodules

A

Bronchoalveolar CA

18
Q

Location of small cell CA

A

Central and apical

19
Q

SSC arise from…. cells

A

Endocrine cells aka Kulchitsky cells aka APUD cells

20
Q

SSC are easily operable at the time of presentation

A

False. Almost inoperable. early spread

21
Q

Does SSC respond to chemo and radiotherapy

22
Q

Clinical features of Bronchial CA

A
  • Cough
  • Chest pain – pleuritic pain
  • Haemoptysis
  • Malaise
  • Weight loss
  • Hoarseness of voice
  • Signs of pleural effusion, collapse
23
Q

Sites of direct spread

A

pleura, ribs
CA apex- lower part of brachial plexus
Hilar tumors- RLN
Phrenic nerve
Superior Vena Cava
Esophagus

24
Q

Manifestations of direct spread to the CA apex

A

horner’s syndrome

25
manifestations of direct spread to the hilum
RLN involvement causes U/L vocal cord paresis, hoarseness, bovine cough
26
Manifestations of direct spread of bronchial CA to the Superior vena cava
early morning headache, facial congestion and oedema of upper limbs
27
Metastatic complications of bronchial CA
* Bone metastases (pathological fractures) * Liver involvement * Brain involvement * Spinal cord compression * Adrenal involvement
28
Sx of Liver involvement of direct spread of bronchial CA
RHC pain LOA Icterus is a very late sign
29
Sx of Brain involvement of direct spread of bronchial CA
early morning headache vomiting adult- onset seizures
30
Non-metastatic extrapulmonary manifestations is also known as
paraneoplastic syndrome
31
Paraneoplastic syndrome in bronchial CA
* Finger clubbing * Hypertrophic pulmonary oesteoarthropathy * Metabolic – loss of weight, anorexia * Endocrine – usually small cell CA o Ectopic ACTH secretion o SIADH o Hypercalcaemia – usually squamous cell CA * Neurological o Encephalopathies (cerevellar degeneration) o MND o Peripheral sensorimotor neuropathy o Muscle disorders o Lambert Eaton syndrome * Vascular o Thromboplebitismigrans o DIC o Haemolytic anaemia * Cutaneous (rare) o Dermatomyositis o Acanthosis nigricans
32
Ix done for Bronchial CA
* CXR * CECT * Fiberoptic bronchoscopy * Percutaneous aspiration and biopsy
33
Mx of bronchial CA
* Surgery – can be curative in non-small cell lung cancer * Radiation therapy for cure (Radiation pneumonitis) * Chemotherapy * Laser therapy, endobronchial irradiation, Stents * Palliative treatment
34
Clubbing DDs
CVS - Cyanotic HD, Atrial myxoma, Inf endocarditis Respi- Bronchiectasis, Lung Abscess, Bronchial CA